The immediate goal of this four-year research career award is to further the candidate's development as a patient-oriented researcher, with a focus on oral health and systemic disease. The career development plan will build on her clinical experience as a General Practice Residency Program director and on her research training in Epidemiology. The long-term goal of the career development plan is to enable the candidate to become an independent investigator in oral and systemic health research and to serve as a mentor for junior patient-oriented researchers. The specific training targets are as follows: 1) Attainment of a solid knowledge base in the design and conduct of clinical trials; 2) coursework and consultation in clinical trial and data analytic methods; 3) understanding of procedural, philosophical, and ethical issues arising in the design and conduct of clinical trials; 4) development, based on results and questions raised by the proposed study, of a multi-site clinical effectiveness trial to improve the oral and systemic health of dependent nursing home patients, and 6) dissemination of research findings to investigators in dentistry and other biomedical fields. Under the mentorship of Dr. Dan Sessler, a senior investigator in clinical trials and Director of the Outcomes Research Institute, Dr. Denis Kinane, a senior research scientist and Director of the Center for Oral Health and Systemic Disease, and Dr. Christine Ritchie, a Geriatric Medicine physician at the Center for Oral Health and Systemic Disease, the candidate will pursue a focused clinical research project and will receive formal and practical instruction in all aspects of clinical investigation. The proposed clinical research is needed to add to the knowledge concerning the role of oral health and systemic disease in a population with health disparities. The candidate's firsthand research training will involve the implementation of a pilot randomized, placebo controlled clinical trial of the effects of chlorhexidine oral spray in reducing pneumonia in dependent nursing home patients. The results of the proposed research will serve as the basis for the design and submission of an investigator-initiated research proposal before the end of the award.